Self-administered abortion pays attention, but helpers risk legal trouble

At a recent rally in Nashville, Tennessee, planned parenthood organizer Julie Edwards looked at some “back-alley abortion” images of symptoms, including bloody coat hangers. In a June 24 decision by the U.S. Supreme Court on the right to abortion, Edwards reminded the crowd that it was not like the day before. Rowe vs. Wade.

About a decade ago, Edwards was a teenager and received medication from elderly friends to end an unintended pregnancy.

“I have had a self-inflicted abortion standing in front of you, I have received abortion pills from people in my community. And I’m safe, “said Edward Cheers. “It’s going to take us all to keep each other’s privacy, to hold each other’s hands, to keep each other safe.”

Self-administered abortions with drugs may become the new norm in abortion-prohibited states like Tennessee. Medications are not new; They have been available in the United States since 2000, so medical risks are known. But now there are legal risks, which may be more for a pregnant woman to help a pregnant woman in this way than for herself. Medications for first trimester abortion are now the primary means of abortion in the United States

The rules contain two prescription drugs that can be used within 10 weeks of pregnancy. Mifepristone is taken first. It is an abortion drug that is fairly expensive and highly regulated. After a day or two, the patient takes misoprostol, which is much more widely available and can act on its own to cause miscarriage. The drug was developed in the 1970s to treat ulcers but has several other off-label uses in addition to abortion, such as relieving arthritis. It is even prescribed for animals, so veterinary supply stores carry drugs. Misoprostol is sold over-the-counter in Mexico.

“It simply came to our notice then. And in a self-administered context, the only way to get mifepristone plus misoprostol is through the internet, so it takes time to wait for delivery, ”said Susan Yano, spokeswoman for Women Help Women, a nonprofit organization that works across four continents and works to increase access to abortion.

The company shifts both drugs around the world – but not in the United States because laws vary greatly by state. Social media sites like Facebook and Instagram have already started pulling posts offering to send these drugs in the mail. Many states that have now banned abortion have recently tightened their laws regarding mail-order abortion drugs.

“We still have the right to share information,” Yano said. “People use the internet. People use their phones. People will find a way to get these pills. “

Women’s demand goes beyond finding drugs, which is why Yano’s company has detailed guidelines on how to use them safely. And she provides training for local reproductive rights groups like no other.

Lance Bork of Montana-based Self-Guided Abortion began making video tutorials late last year and publishing them on YouTube, explaining how to use misoprostol alone and further sanctifying the process by building an altar, burning incense and lighting. Suggests ways. Candles He even gives instructions on post-abortion yoga.

Multiple doses with misoprostol alone are required. Nausea is common. And the drug induces cramping and bleeding which can be worrisome for those who are not ready.

Even some OB-GYNs quietly support self-administered abortion.

“I’m more concerned about people who can’t go to one of these sources and they’re so desperate that they take matters into their own hands,” said Dr. Nikki Jite, OB-GYN of the University of Tennessee Medical Center.

She said clinical counseling is ideal before taking the pill combo. For example, some patients are anemic and may have enough bleeding in need of emergency care. And some don’t do well with just pain and lots of blood.

“Not every patient is a good candidate to have an abortion at home,” she said.

But at the moment, Zite says, he can’t provide that advice. In Tennessee, she will now be at risk of a felony and jail time under a six-week ban in effect, and an all-out abortion ban will take effect by August. And it’s not clear how far law enforcement is willing to go.

Tennessee law specifically exempts a pregnant woman from trial. But a motivated prosecutor could find a way to press charges against a self-administered abortion, said Nashville Criminal Defense Attorney David Robin.

“I mean, it’s full of danger,” Rabin said. “I would strongly recommend a woman get this type of drug using the ‘underground method’ of such quotes.”

He said it was better to have a legal abortion in another state. But Tennessee abortion rights activists say they know it will be difficult for many to travel. And even for those who can travel, a self-managed abortion may be more convenient. To some extent, however, reproductive rights groups are willing to help navigate the legal gray area.

Healthy & Free Tennessee, an organization working to promote sexual health and reproductive freedom, has organized a number of training sessions through Women Help Women in recent weeks. Policy Director Nina Gurak says the group’s biggest concern is not health complications – it’s a legal risk.

“We recommend that if someone self-manages an abortion they have a supporter or friend. That supporter or friend may be at a higher legal risk than the actual person who is conducting the abortion himself, ”he said.“ And then you have to decide for yourself – is that something I feel comfortable with? Is that something I don’t feel comfortable with? “

State agencies, including abortion bans, have their own risk of assessment. They feel confident that the First Amendment protects the sharing of medical information approved by the World Health Organization.

But proponents of abortion rights are torn between raising awareness and becoming the target of anti-abortion lawmakers – who are no longer restricted by constitutional protections. Rowe vs. Wade Is provided

“We are certainly concerned about abortion or self-administered abortion and the criminalization of abortion pills,” Gurak said. “We want to balance the information the community needs that they have to decide for themselves.”

The story is part of a partnership that includes Nashville Public Radio, NPR and KHN.

KHN (Kaiser Health News) is a national newsroom that creates in-depth journalism about health issues. KHN is one of the three major operating programs of KFF (Kaiser Family Foundation), including policy analysis and polling. KFF is a non-profit organization that provides health information to the nation.

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